During the first four years of this grant, a series of steps were taken to develop a multi-dimensional, multi-disciplinary approach to measuring the effects of alternative ways for providing health care services to three geographically defined areas in Nashville's predominantly black ghetto; one area has a neighborhood comprehensive services health center with comprehensive outreach services, the second a hosptial-based comprehensive health center for both adults and children with limited outreach services, and the third, was served by the "traditional" services available to the poor. An unmet needs study obtained detailed consumer and provider judgments about care being received and needed in the areas of medical, dental, nursing and psychosocial needs. It is anticipated that the unmet needs study will conduct a second survey to ascertain any impact on levels of needs created by the new models of health services. A patient satisfaction study is under way among mothers of all babies delivered from the study areas in 1973. Monitoring of birth and perinatal death certificates continues as another outcome measure of the health care delivery system models.